Healthcare Provider Details
I. General information
NPI: 1295299527
Provider Name (Legal Business Name): CLAYTON J CARTER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/31/2019
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3489 W 2100 S STE 350
WEST VALLEY CITY UT
84119-5897
US
IV. Provider business mailing address
402 WINCHESTER DR
STANSBURY PARK UT
84074-8212
US
V. Phone/Fax
- Phone: 385-324-2508
- Fax:
- Phone: 435-225-6706
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 7069676-1701 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: